MEDICARE: MEGAN LYNN FOREMAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	DP00944641	WV
2	225C00000X	Rehabilitation Counselor
3	1041C0700X	Clinical Social Worker	107680	TX

General Provider Information

NPI Number	:	1043427511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN LYNN FOREMAN LCSW

Provider Business Mailing Address
First Line	:	4410 W VICKERY BLVD STE 204
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6256
Country	:	US
Telephone Number	:	817-720-0382
Fax Number	:

Provider Business Practice Location Address
First Line	:	4410 W VICKERY BLVD STE 204
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6256
Country	:	US
Telephone Number	:	817-720-0382
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	03/22/2023

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